Optimizing Stroke Therapy - Advanced Brain Imaging And Reperfusion Therapies
Funder
National Health and Medical Research Council
Funding Amount
$419,180.00
Summary
Most stroke is due to a blocked blood vessel reducing blood flow to the brain. This research aims to optimize fast restoration of blood flow to the brain and improve patient outcomes. We will test potentially more effective clot-dissolving medication, examine potential benefits of redesigning pre-hospital ambulance transport systems and clarify the role of advanced brain imaging to maximize delivery of recently proven minimally invasive procedures to physically remove blood clots in the brain.
Thrombolysis is a method of dissolving the blood clot that is the cause of the majority of strokes in Australia. The first major trial to demonstrate benefit for this treatment was published some 11 years ago but treatment has not been widely implemented across Australia because of the difficulties in giving treatment within the very tight time window for which treatment is currently approved (patients must get to hospital, be scanned and start treatment within 3 hours of the onset of the stroke ....Thrombolysis is a method of dissolving the blood clot that is the cause of the majority of strokes in Australia. The first major trial to demonstrate benefit for this treatment was published some 11 years ago but treatment has not been widely implemented across Australia because of the difficulties in giving treatment within the very tight time window for which treatment is currently approved (patients must get to hospital, be scanned and start treatment within 3 hours of the onset of the stroke). Other factors which have limited implementation of treatment in Australia are continued debate over the trial data for this treatment as only one of the 5 major trials was positive. In addition, virtually no patients aged over 80 years old were included in the previous trials, and as this age group represents about a third of all stroke in Australia, new data in this age group is required. As a result of the difficulty in giving a treatment within such a tight time window and the ongoing debate about the trial data, few Australians are currently treated and thus the public health impact is negligible. In to change clinical practice, we need reliable data from a large convincing further trial of thrombolysis with the more realistic time window of 6 hours. The Third International Stroke Trial (IST-3) is a large international collaborative effort to determine whether thrombolysis treatment offered to a wider range of patients up to 6 hours from stroke onset results in an increase in long-term independent survival. Data from such a trial is most likely to change clinical practice and lead to an important public health benefit.Read moreRead less
Imaging Of Acute Ischemic Stroke – Improving Patient Selection For Thrombolysis
Funder
National Health and Medical Research Council
Funding Amount
$367,946.00
Summary
Stroke is a major cause of death and disability in our community and is most often due to a blocked blood vessel. Powerful treatments are available to open blocked blood vessels but there are restrictions on eligibility and some risks. This research aims to improve doctors' understanding of stroke in the individual patient to aid treatment decisions by identifying those with potentially salvageable brain tissue and avoiding those with high risk of bleeding complications.
Enhanced Control Of Hypertension And Thrombolysis In Stroke Study (STAY ENCHANTED)
Funder
National Health and Medical Research Council
Funding Amount
$2,437,384.00
Summary
"Clot busting" treatment is the only approved medical treatment for the commonest type of stroke, ischaemic stroke. However, uptake of treatment remains poor, mainly due to the known major risk of bleeding in the brain. STAY ENCHANTED is an international clinical trial to investigate whether "clot-busting" can be made safer using a lower dose and/or immediate blood pressure lowering. A safer more effective regime could have a major global health impact.
EXTEND-IA Randomized Trial Of Intra-arterial Clot Retrieval In Ischemic Stroke
Funder
National Health and Medical Research Council
Funding Amount
$764,534.00
Summary
Most strokes are caused by a blocked blood vessel in the brain. Current treatments to dissolve the blockage improve recovery for many patients but often fail to unblock larger brain arteries. The EXTEND-IA trial will use advanced brain imaging to identify patients who have the most to gain if the blocked artery can be re-opened. The trial will test whether a new minimally invasive clot removal procedure performed after standard clot-dissolving treatment improves recovery after stroke.